"I just drove to the store for some Preparation H" - Ben Folds, Rocking the Suburbs
"Preparation A to G failed, I call this device Preparation H" - Dr Evil, Austin Powers
"I'm looking for the Preparation H" - Random customer scanning the hair-care section.
"You know that Preparation H is an American brand that isn't sold in Australia?" - Me
"No, but I need Preparation H" - Random customer replies, moving towards the baby section hoping the Preparation H is actually over there.
It's usually at this stage that I have bite my fist, lest I say what I am actually thinking rather than present the appropriate "caring pharmacist" front.
Requests for Preparation H happen often enough to make me wonder how people know about it. As something of a pop-culture vulture, the two aforementioned examples are the only instances I can think of where an Australian would be introduced to the product.
However it appears that with the recent dirge of TV medical-dramas, patients have been listening intently and building an armamentarium of medical knowledge and a vocabulary of key-words - some shouted by Dr House others by that lesbian one from that other show. If someone on TV mentions that Preparation H is used for haemorrhoids then it must be the gold-standard treatment. To my public, an endorsement by House MD or that horsey-looking guy off Scrubs is second only to an infomercial hosted by Nelson Mandela.
A brief digression - the first and only episode of House I saw, it ended up that the patient was sick and it was all the pharmacist's fault. I can't remember the specifics but I was angry and felt a need for pharmacist solidarity. Fuck you, House MD -I liked you better when you had an English accent and you were called "Percy". An incident with Jesse Spencer at the Torquay Palace Hotel in 1994 further diminished my enthusiasm for the show. All these years later I still think the bloke is a wanker.
So it seems that TV and the Internet is turning everyone in to a medical expert. Endorsements or even passing mentions of specific products in these mediums can present significant commercial opportunities to brands. It really is a pain in the arse convincing someone that just because Dr House or De Evil said it, it ain't necessarily so - or more correctly, relevant.
The marketing implications for this kind of brand awareness is an interesting aside. At no expense or effort on their behalf, Wyeth have captured a brand awareness and demand for a product in a country where that product is neither marketed nor available. Of course, this is a one off example. In these days of product placement and commercial tie-ins this kind of exposure comes at a cost. But the Preparation H example in an interesting one, no?
Saturday, April 18, 2009
Evaluation of patient attitudes towards QUM interventions of benzodiazepine use in the general population
Aim: To evaluate patient attitudes towards pharmacist interventions made against non-QUM use of benzodiazepine medications.
Method: To be conducted over the period of a normal working week (five days, 40 hours - April 2009) as a pharmacist, patients observed to be using benzodiazepine medications outside guidelines recommended by QUM-principles and current therapeutic guidelines (Therapeutic Guidelines, Australian Medication Handbook) will be counseled in an attempt to normalise or cease their use of this class of medication.
"Non-QUM usage" is defined as on-going benzodiazepine use averaging at least daily usage over a period of no less than six months. The frequency and duration of treatment will be elucidated via patient dispensing records on the MINFOS dispensing system. Patients that fall outside these criteria yet demonstrate obvious or potential non-QUM benzodiazepine use will also be included at the discression of the investigator.
Interventions will be made in the form of patient counselling based on the Professional Practice Standards as set out by the Australian Pharmaceutical Formulary (APF) Edition 21. Interventions will focus on non-drug (lifestyle) therapies, complimentary and alternative medical alternatives and any other option deemed appropriate, where appropriate.
De-identified records of each intervention will be be kept on a scrap of paper in the investigator's back right-hand pocket and collated at the end of the evaluation period.
Results, discussion and conclusion to be published following trial period.
Wish me luck.
Method: To be conducted over the period of a normal working week (five days, 40 hours - April 2009) as a pharmacist, patients observed to be using benzodiazepine medications outside guidelines recommended by QUM-principles and current therapeutic guidelines (Therapeutic Guidelines, Australian Medication Handbook) will be counseled in an attempt to normalise or cease their use of this class of medication.
"Non-QUM usage" is defined as on-going benzodiazepine use averaging at least daily usage over a period of no less than six months. The frequency and duration of treatment will be elucidated via patient dispensing records on the MINFOS dispensing system. Patients that fall outside these criteria yet demonstrate obvious or potential non-QUM benzodiazepine use will also be included at the discression of the investigator.
Interventions will be made in the form of patient counselling based on the Professional Practice Standards as set out by the Australian Pharmaceutical Formulary (APF) Edition 21. Interventions will focus on non-drug (lifestyle) therapies, complimentary and alternative medical alternatives and any other option deemed appropriate, where appropriate.
De-identified records of each intervention will be be kept on a scrap of paper in the investigator's back right-hand pocket and collated at the end of the evaluation period.
Results, discussion and conclusion to be published following trial period.
Wish me luck.
Upsetting mothers
Well, I didn't do it on purpose....
Mother - sans child - presents script for Amoxil syrup for her youngest.
"Would you like the generic brand on that one? Five or ten minutes, blah blah blah, entertain yourself in the meantime by looking at our lovely new fish tank. I call the blue one Wayne".
The preparation was finalised with the addition of 87mL of water, the stickers were stuck and I gave the bottle the vigorous shake as suggested by one of the aforementioned stickers.
Counselling time.
"Hi. Have you seen this antibiotic before?"
"No"
The counselling began and ended uneventfully.
I tried finishing with some colour; "It's a nice tasting one. You shouldn't have too much trouble getting it in to her. She'll love the taste."
"Excuse me, [patient's name] is a boy" snapped the mother.
"Oh, I'm sorry".
"Why would you assume [patient's name] is a girl?" sniped mum, obviously pissed off.
"Hah hah" I nervously laughed, "you'll have to excuse me, I often say stupid things".
"Clearly" said mum, as she huffed and turned on her heels.
Oh how I would love to tell you the child's name. It's not as obviously feminine as the example made famous by Johnny Cash - it's one of those new-fangled Rikki Lake Show type-names that you usually see attached to a girl.
So my message is; mothers, if you're liable to get pissed off by a stranger mistaking your son for a daughter because of their name, don't give them a girl's name. Simple.
Mother - sans child - presents script for Amoxil syrup for her youngest.
"Would you like the generic brand on that one? Five or ten minutes, blah blah blah, entertain yourself in the meantime by looking at our lovely new fish tank. I call the blue one Wayne".
The preparation was finalised with the addition of 87mL of water, the stickers were stuck and I gave the bottle the vigorous shake as suggested by one of the aforementioned stickers.
Counselling time.
"Hi. Have you seen this antibiotic before?"
"No"
The counselling began and ended uneventfully.
I tried finishing with some colour; "It's a nice tasting one. You shouldn't have too much trouble getting it in to her. She'll love the taste."
"Excuse me, [patient's name] is a boy" snapped the mother.
"Oh, I'm sorry".
"Why would you assume [patient's name] is a girl?" sniped mum, obviously pissed off.
"Hah hah" I nervously laughed, "you'll have to excuse me, I often say stupid things".
"Clearly" said mum, as she huffed and turned on her heels.
Oh how I would love to tell you the child's name. It's not as obviously feminine as the example made famous by Johnny Cash - it's one of those new-fangled Rikki Lake Show type-names that you usually see attached to a girl.
So my message is; mothers, if you're liable to get pissed off by a stranger mistaking your son for a daughter because of their name, don't give them a girl's name. Simple.
Wednesday, January 14, 2009
Cheech and Chong vs The Man in the White Coat
....a title both worthy and indicative of Cheech and Chong's increasingly rubbish artistic output.
Cynicism is as much a part of being a pharmacist as hash-browns are to a McDonald's breakfast. The default setting for myself and almost every other pharmacist I know is the "how is this person trying to trick me?" mode; listening intently for the tell that proves that the patient is trying one on.
Some patients are better than others at decieving the pharmacist. The best - in my experience at least - are the ones that you are screening out in the first place. Pseudo runners, benzo addicts, opiate fiends and methadone or bupe regulars are informed, switched on and have the correct answer for everything. I'm not ashamed to admit that I have been made to look like a gullible idiot on more than one occasion by one or more of this group.
Today I had an experience at the other end of the spectrum;
Two giant meat-headed gym-junkie types do their "carrying watermelons" walk into the pharmacy. Unsurprisingly I notice them almost immediately - their freakish size stands out somewhat.
"Hey guys, how can I help you?"
"Uh, yea. Um, my uncle is a diabetic and he needs some syringes....can we have some for him?" starts the slightly smaller one
"Sorry?" I look perplexed.
A variation on the request is repeated by the other guy.
"Come on guys...does that story ever work?" I laugh, confident in the fact that if the comment offended I could easily outrun and outmaneuver them.
"Huh? Nah seriously, umm, my uncle is diabetic....I need some syringes for him" said the smaller one again.
"Do you have his diabetes card, or medicare card?"
"No"
I lean over the counter. "Look dude, go to the pharmacy a couple of blocks away and get a fit pack, they're only a couple of dollars and they won't ask any questions".
Their concern for the uncle evaporated and they walked their freakish thigh-chaffing walk out of the pharmacy.
If only they were all that easy.
Cynicism is as much a part of being a pharmacist as hash-browns are to a McDonald's breakfast. The default setting for myself and almost every other pharmacist I know is the "how is this person trying to trick me?" mode; listening intently for the tell that proves that the patient is trying one on.
Some patients are better than others at decieving the pharmacist. The best - in my experience at least - are the ones that you are screening out in the first place. Pseudo runners, benzo addicts, opiate fiends and methadone or bupe regulars are informed, switched on and have the correct answer for everything. I'm not ashamed to admit that I have been made to look like a gullible idiot on more than one occasion by one or more of this group.
Today I had an experience at the other end of the spectrum;
Two giant meat-headed gym-junkie types do their "carrying watermelons" walk into the pharmacy. Unsurprisingly I notice them almost immediately - their freakish size stands out somewhat.
"Hey guys, how can I help you?"
"Uh, yea. Um, my uncle is a diabetic and he needs some syringes....can we have some for him?" starts the slightly smaller one
"Sorry?" I look perplexed.
A variation on the request is repeated by the other guy.
"Come on guys...does that story ever work?" I laugh, confident in the fact that if the comment offended I could easily outrun and outmaneuver them.
"Huh? Nah seriously, umm, my uncle is diabetic....I need some syringes for him" said the smaller one again.
"Do you have his diabetes card, or medicare card?"
"No"
I lean over the counter. "Look dude, go to the pharmacy a couple of blocks away and get a fit pack, they're only a couple of dollars and they won't ask any questions".
Their concern for the uncle evaporated and they walked their freakish thigh-chaffing walk out of the pharmacy.
If only they were all that easy.
Wednesday, January 7, 2009
Nurses, bless 'em...
"It's okay, I'm a nurse" is never a good way to brush off a pharmacist. A show of professional dick-waving like that might work on the shop girls, but ask any pharmacist and they'll probably just roll their eyes and gear up for a fight.
It's almost a universal response with pharmacists. Whenever a customer explains that they are a nurse and already know everything they need to know, it invariably means that they actually know sweet-F-A about the medication and in truth, resent being spoken down to by a pharmacist.
A recent case-in-point;
I won't bore you with the minutiae, but the general gist of the interaction was that the patient had sprained her back and required some Nurfoen. On furthur questioning it turned out that said customer was also using Celebrex for oesteoarthritis in her fingers and had been using OTC Zantac for some time.
I was ready to counsel the shit out of her. To use a cricketing analogy the scenario was a cream-puff bowled full and wide of off-stump by a part time chinaman. It was there to be slogged for six, right into Bay 13 and the hoards of drunken youths.
Just as I was getting into full swing she cut me off;
"Oh I'm a nurse, I know all about this" she said.
I reiterated, trying to ensure she understood the relevance of her GIT symptoms in light of her NSAID use - she glared at me like I had just molested one of her children. The most prudent course of action, in my estimation, was to back off.
And so ended yet another successful counselling episode involving a nurse. I sometimes wonder whether she genuinely understood what was going on and had the situation under control, or whether she just didn't want to hear it from a pharmacist.
It's almost a universal response with pharmacists. Whenever a customer explains that they are a nurse and already know everything they need to know, it invariably means that they actually know sweet-F-A about the medication and in truth, resent being spoken down to by a pharmacist.
A recent case-in-point;
I won't bore you with the minutiae, but the general gist of the interaction was that the patient had sprained her back and required some Nurfoen. On furthur questioning it turned out that said customer was also using Celebrex for oesteoarthritis in her fingers and had been using OTC Zantac for some time.
I was ready to counsel the shit out of her. To use a cricketing analogy the scenario was a cream-puff bowled full and wide of off-stump by a part time chinaman. It was there to be slogged for six, right into Bay 13 and the hoards of drunken youths.
Just as I was getting into full swing she cut me off;
"Oh I'm a nurse, I know all about this" she said.
I reiterated, trying to ensure she understood the relevance of her GIT symptoms in light of her NSAID use - she glared at me like I had just molested one of her children. The most prudent course of action, in my estimation, was to back off.
And so ended yet another successful counselling episode involving a nurse. I sometimes wonder whether she genuinely understood what was going on and had the situation under control, or whether she just didn't want to hear it from a pharmacist.
Sunday, December 28, 2008
Two levels of expert?
As a pharmacist I am an expert at many things.
I'm an expert in folding an A4 pharmacy receipt in thirds so that it will fit into an envelope; I'm an expert at making polite small-talk with people I find objectionable, nodding and smiling in all the right places; and I'm an expert at light-flirting with shop girls. I'm a man of many talents - some more tangible than others.
I do have one real tangible piece of expertise; I have a pharmacy degree - the documentary evidence is hanging on the wall at my parents' house. On top of that I have a card that tells me that I am registered with my state's Pharmacy Board, they having judged me "competent enough" to practice pharmacy in their state.
You'd expect that with my significant education and pat on the back from the state regulatory authority permitting me to practice I would be considered an expert in pharmacy and pharmaceuticals. Well, yes technically I am - everyone knows that pharmacists are experts on pharmaceuticals...duh. Why then do I need to undertake a suspiciously expensive training course to allow me to review a patent's medications in their home, and then write a report for the doctor?
I'm talking about HMR's and DMMR's - Home Medication Reviews. From the link;
"The Home Medicines Review (HMR) is funded under the Fourth Community Pharmacy Agreement designed to assist consumers living at home to maximise the benefits of their medication regimen and prevent medication related problems....[they are conducted by] an accredited pharmacist [who is]; an experienced pharmacist who has undertaken specified education programs or examinations, approved by the Australian Association of Consultant Pharmacy (AACP) or the Society of Hospital Pharmacist Australia (SHPA)."
Currently I'm not an accredited pharmacist...and I don't think I want to be one to be quite honest.
To become accredited I'd need to sit a number of exams containing questions the answers to which any competent pharmacist should know, or at least know where to find. On top of this I would need to submit proof of my competency in medication management - seconded by another pharmacist - and spend around $2,500 to achieve the AACP post-nominals. The reaccreditation process needs to be completed every three years.
Occasionally on slow afternoons I participate in some self-directed continuing professional education - just to keep tight on my mad pharmaczism skillz . For instance, one afternoon I refreshed my memory on the viral hemorrhagic fevers. Admittedly it's unlikely I'll come across a Lassa or Hanta between the interminable requests for thrush cream and child sedatives, but it's good to be prepared none-the-less. Similarly, I was forced to CPE my own ass after a discussion with an infrequently seen older and more grizzled colleague regarding my diagnosis of a kid with Fifth Disease.
"Ahhh....Slapped Cheek Syndrome" said Grizzled Older Colleague, "needs to go to the doctor for that one".
"Errr, no he doesn't" I replied
"Err...yes he does" came the slightly more forceful reply, aimed over a pair of overpriced fashion glasses and down his ruddy nose, "the child needs erythromycin".
"If he had an URTI maybe. Not for Fifth."
"So why doesn't he need antibiotics then?"
"It's a virus. Poxo or paro or some shit....I can't remember the name. Self limiting. Give the parents a Valium and tell them to wait five days - that type of shit".
I tired of the conversation and went and made a beverage. I later confirmed my diagnosis and recommendations via my three favourite resources; wikipedia, Mosby's, and Merck. I did not bother to inform Grizzled Colleague - for he is a cunt. It was a conclusion I'd reached several months earlier and had yet again been validated.
For shits and giggles I recently decided to try my hand at some of the sample questions posted on the AACP website for the Accreditation Exam. I found the task demoralising and frustrating; not because the questions were particularly difficult, but because they were written in such a sneaky and oblique fashion as to make selecting the correct answer as much about chance as good clinical knowledge.
Take this sample question for example;
An 89 year old woman has a history of polymyalgia rheumatica, osteoarthritis and hypertension.
Her current medications are:
Prednisolone 5mg daily
Verapamil 240mg SR daily
Temazepam 10mg n
Coloxyl and Senna 2 n regularly + 1 m prn
Ferrous sulphate 325mg daily
Frusemide 20mg daily
Paracetamol 1g qid prn (takes these ~ twice daily)
Recent blood tests showed the following:
Sodium 138mmol/L (135-145mmol/L)
Potassium 4.2mmol/L (3.0 - 5.2mmol/L)
Creatinine 50micromol/L (<80micromol/L)
Haemoglobin 101g/L (115-135g/)
MCV 96fL (80-100fL)
Which ONE of the following issues would be the LEAST APPROPRIATE to investigate further?
a Her verapamil may be contributing to her constipation (she is taking coloxyl and senna) and a change to an alternative antihypertensive may be considered.
b The laboratory tests are not consistent with an iron deficiency anaemia and a review of the need for the iron supplement would be appropriate
c The prednisolone may be contributing to her hypertension and its use should be reviewed
d The verapamil may be contributing to her oedema (she is taking frusemide), and a change to an alternative antihypertensive may be considered
e The iron supplement may be contributing to her constipation (she is taking coloxyl and senna), and , given the laboratory tests, its use may be reconsidered
That's my emphasis placed on the "LEAST APPROPRIATE".
I think it's dead sneaky and kind of patronising to try and trick someone like this - particularly that when the answer is known it seems clear the author wrote the question around the answer and the the correctness of one answer over another can be expressed either as a function of the individual's subjective opinion, or the magnitude of a bee's reproductive organ.
"Least appropriate"? A shit qualifier for a question. There's two answers there that could be correct. Three if you wanted topassionatly argue the point. Pick the wrong one and you're in trouble because the minimum pass-mark is 75%. Fail twice and you're up for another exam fee.
Here's one for you;
I go to dinner at a girlfriend's house. What is the LEAST APPROPRIATE thing to do whilst seated at the dinner-table?
a. Tell Nana she has a nice rack
b. Cup-cake the girlfriend (see definition #6 of link)
c. Tell mum that the roast dinner is dry and to "cook me some fucking eggs"
d. Insist to dad that he doesn't have much of a physical resemblance to his "daughter" - being sure to use air-quotes when referring to said child and insisting that as a pharmacist andhealthcare professional "you just know these things".
e. Embark on lengthy anecdotes with a "race-hate" motif.
A good point, humorously made.
There does, however, remain the problem of two layers of experts in pharmacy. I know that an AACP-accredited pharmacist is not necessarily more knowledgeable or competent that I; however I do know that they are more knowledgeable and competent than Grizzled Older Colleague.
Why then would it cost me so much money and time to prove my ability and achieve AACP status? Why can't the shit pharmacists - the ones who think parovirus is treated with erythromycin and argue that because homeopathy works on animals that it actually does work - regularly prove their suitability to practice?
Shouldn't all pharmacists have regular evaluations of competency? As it says on the AACP website "accredited pharmacists are committed to life-long learning and staying current with best-practice knowledge" but really, shouldn't we all?
I'm an expert in folding an A4 pharmacy receipt in thirds so that it will fit into an envelope; I'm an expert at making polite small-talk with people I find objectionable, nodding and smiling in all the right places; and I'm an expert at light-flirting with shop girls. I'm a man of many talents - some more tangible than others.
I do have one real tangible piece of expertise; I have a pharmacy degree - the documentary evidence is hanging on the wall at my parents' house. On top of that I have a card that tells me that I am registered with my state's Pharmacy Board, they having judged me "competent enough" to practice pharmacy in their state.
You'd expect that with my significant education and pat on the back from the state regulatory authority permitting me to practice I would be considered an expert in pharmacy and pharmaceuticals. Well, yes technically I am - everyone knows that pharmacists are experts on pharmaceuticals...duh. Why then do I need to undertake a suspiciously expensive training course to allow me to review a patent's medications in their home, and then write a report for the doctor?
I'm talking about HMR's and DMMR's - Home Medication Reviews. From the link;
"The Home Medicines Review (HMR) is funded under the Fourth Community Pharmacy Agreement designed to assist consumers living at home to maximise the benefits of their medication regimen and prevent medication related problems....[they are conducted by] an accredited pharmacist [who is]; an experienced pharmacist who has undertaken specified education programs or examinations, approved by the Australian Association of Consultant Pharmacy (AACP) or the Society of Hospital Pharmacist Australia (SHPA)."
Currently I'm not an accredited pharmacist...and I don't think I want to be one to be quite honest.
To become accredited I'd need to sit a number of exams containing questions the answers to which any competent pharmacist should know, or at least know where to find. On top of this I would need to submit proof of my competency in medication management - seconded by another pharmacist - and spend around $2,500 to achieve the AACP post-nominals. The reaccreditation process needs to be completed every three years.
Occasionally on slow afternoons I participate in some self-directed continuing professional education - just to keep tight on my mad pharmaczism skillz . For instance, one afternoon I refreshed my memory on the viral hemorrhagic fevers. Admittedly it's unlikely I'll come across a Lassa or Hanta between the interminable requests for thrush cream and child sedatives, but it's good to be prepared none-the-less. Similarly, I was forced to CPE my own ass after a discussion with an infrequently seen older and more grizzled colleague regarding my diagnosis of a kid with Fifth Disease.
"Ahhh....Slapped Cheek Syndrome" said Grizzled Older Colleague, "needs to go to the doctor for that one".
"Errr, no he doesn't" I replied
"Err...yes he does" came the slightly more forceful reply, aimed over a pair of overpriced fashion glasses and down his ruddy nose, "the child needs erythromycin".
"If he had an URTI maybe. Not for Fifth."
"So why doesn't he need antibiotics then?"
"It's a virus. Poxo or paro or some shit....I can't remember the name. Self limiting. Give the parents a Valium and tell them to wait five days - that type of shit".
I tired of the conversation and went and made a beverage. I later confirmed my diagnosis and recommendations via my three favourite resources; wikipedia, Mosby's, and Merck. I did not bother to inform Grizzled Colleague - for he is a cunt. It was a conclusion I'd reached several months earlier and had yet again been validated.
For shits and giggles I recently decided to try my hand at some of the sample questions posted on the AACP website for the Accreditation Exam. I found the task demoralising and frustrating; not because the questions were particularly difficult, but because they were written in such a sneaky and oblique fashion as to make selecting the correct answer as much about chance as good clinical knowledge.
Take this sample question for example;
An 89 year old woman has a history of polymyalgia rheumatica, osteoarthritis and hypertension.
Her current medications are:
Prednisolone 5mg daily
Verapamil 240mg SR daily
Temazepam 10mg n
Coloxyl and Senna 2 n regularly + 1 m prn
Ferrous sulphate 325mg daily
Frusemide 20mg daily
Paracetamol 1g qid prn (takes these ~ twice daily)
Recent blood tests showed the following:
Sodium 138mmol/L (135-145mmol/L)
Potassium 4.2mmol/L (3.0 - 5.2mmol/L)
Creatinine 50micromol/L (<80micromol/L)
Haemoglobin 101g/L (115-135g/)
MCV 96fL (80-100fL)
Which ONE of the following issues would be the LEAST APPROPRIATE to investigate further?
a Her verapamil may be contributing to her constipation (she is taking coloxyl and senna) and a change to an alternative antihypertensive may be considered.
b The laboratory tests are not consistent with an iron deficiency anaemia and a review of the need for the iron supplement would be appropriate
c The prednisolone may be contributing to her hypertension and its use should be reviewed
d The verapamil may be contributing to her oedema (she is taking frusemide), and a change to an alternative antihypertensive may be considered
e The iron supplement may be contributing to her constipation (she is taking coloxyl and senna), and , given the laboratory tests, its use may be reconsidered
That's my emphasis placed on the "LEAST APPROPRIATE".
I think it's dead sneaky and kind of patronising to try and trick someone like this - particularly that when the answer is known it seems clear the author wrote the question around the answer and the the correctness of one answer over another can be expressed either as a function of the individual's subjective opinion, or the magnitude of a bee's reproductive organ.
"Least appropriate"? A shit qualifier for a question. There's two answers there that could be correct. Three if you wanted topassionatly argue the point. Pick the wrong one and you're in trouble because the minimum pass-mark is 75%. Fail twice and you're up for another exam fee.
Here's one for you;
I go to dinner at a girlfriend's house. What is the LEAST APPROPRIATE thing to do whilst seated at the dinner-table?
a. Tell Nana she has a nice rack
b. Cup-cake the girlfriend (see definition #6 of link)
c. Tell mum that the roast dinner is dry and to "cook me some fucking eggs"
d. Insist to dad that he doesn't have much of a physical resemblance to his "daughter" - being sure to use air-quotes when referring to said child and insisting that as a pharmacist andhealthcare professional "you just know these things".
e. Embark on lengthy anecdotes with a "race-hate" motif.
A good point, humorously made.
There does, however, remain the problem of two layers of experts in pharmacy. I know that an AACP-accredited pharmacist is not necessarily more knowledgeable or competent that I; however I do know that they are more knowledgeable and competent than Grizzled Older Colleague.
Why then would it cost me so much money and time to prove my ability and achieve AACP status? Why can't the shit pharmacists - the ones who think parovirus is treated with erythromycin and argue that because homeopathy works on animals that it actually does work - regularly prove their suitability to practice?
Shouldn't all pharmacists have regular evaluations of competency? As it says on the AACP website "accredited pharmacists are committed to life-long learning and staying current with best-practice knowledge" but really, shouldn't we all?
Friday, December 26, 2008
A poorly concieved rant on the state of popular music
I've written before of my deep loathing of commercial radio - my hatred continues to burn with the intensity of one of those green laser pens people sometimes point at planes.
Out jogging today "God Only Knows" by the Beach Boys played on my iPod's random shuffle. It's not exactly the best song to jog to (I prefer "BOB" by Outkast - it has the perfect BPM for jogging), but indisputably one the greatest songs ever written. Everyone agrees with me on this point; Hanson, Bono, Paul McCartney too - and he was 50% of Lennon/McCartney, a pairing who have written some songs of note.
A song of "God Only Knows" quality is unlikely to be played on an Austereo or Macquarie owned radio-station. Why? Because nothing of that quality fits their playlist genre. In fact, there's not much around these days that can match what Brian Wilson, a 32-track mixer, and several instruments can do.
So we look to the artists; the big ones dominating the charts right now. I think a rule should be enforced to make them more accountable for their product.
On releasing a single for general release the artist should publicly declare that - to the best of their ability - their product has been made to a standard as fine as "God Only Knows". They should have shed blood, sweat and tears in bringing forth what they feel is an opus - the absolute pinnacle of their talent as an artist.
I would like to see Pink defend the artistic quality of her releases. Similarly, Nickleback - a band who were recently on the receiving end of what is in all likelihood the greatest simile of all time;
"Nickelback's Rockstar - the musical equivalent of the last hot drips of salty diarrhoea to drip from your arse during a particularly violent bout of food poisoning" - Charlie Brooker, The Guardian 20/12/2008.
I promise a well written pharmacy-related post next week.
Out jogging today "God Only Knows" by the Beach Boys played on my iPod's random shuffle. It's not exactly the best song to jog to (I prefer "BOB" by Outkast - it has the perfect BPM for jogging), but indisputably one the greatest songs ever written. Everyone agrees with me on this point; Hanson, Bono, Paul McCartney too - and he was 50% of Lennon/McCartney, a pairing who have written some songs of note.
A song of "God Only Knows" quality is unlikely to be played on an Austereo or Macquarie owned radio-station. Why? Because nothing of that quality fits their playlist genre. In fact, there's not much around these days that can match what Brian Wilson, a 32-track mixer, and several instruments can do.
So we look to the artists; the big ones dominating the charts right now. I think a rule should be enforced to make them more accountable for their product.
On releasing a single for general release the artist should publicly declare that - to the best of their ability - their product has been made to a standard as fine as "God Only Knows". They should have shed blood, sweat and tears in bringing forth what they feel is an opus - the absolute pinnacle of their talent as an artist.
I would like to see Pink defend the artistic quality of her releases. Similarly, Nickleback - a band who were recently on the receiving end of what is in all likelihood the greatest simile of all time;
"Nickelback's Rockstar - the musical equivalent of the last hot drips of salty diarrhoea to drip from your arse during a particularly violent bout of food poisoning" - Charlie Brooker, The Guardian 20/12/2008.
I promise a well written pharmacy-related post next week.
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